Urban vaccine uptake among marginalized groups reflects a mix of structural barriers, social trustvaccine confidence hinges on perceptions of health systems and governance, while Cornelia Betsch University of Erfurt offers a psychological framework identifying confidence, complacency, constraints, calculation, and collective responsibility as core determinants. These findings help explain why densely populated, low-income neighborhoods can show lower immunization rates despite high disease risk.
Structural and social drivers
Physical and economic obstacles shape access to vaccination services. Clinic location, opening hours, transportation costs, and informal work schedules interact with constraints identified by Cornelia Betsch University of Erfurt to limit practical uptake. Territorial realities such as overcrowded informal settlements and tenuous housing reduce people’s ability to seek preventive care, and precarious legal status or fear of data-sharing with authorities can further deter visits to public clinics. Social determinants—income, education, and neighborhood investment—therefore operate alongside service design to produce gaps in coverage.
Communication, culture, and consequences
Misinformation, historical mistreatment by medical systems, and cultural beliefs undermine trust
Addressing low uptake requires multi-level interventions that combine service redesign to reduce constraints, community-led communication to rebuild confidenceNuanced attention to local cultural and territorial contexts determines whether these measures translate into improved vaccination rates and more equitable urban health.